Michigan moves toward Medicaid change

Michigan took a big step Tuesday toward signing up for Obamacare’s massive Medicaid expansion, giving GOP Gov. Rick Snyder a long-sought victory to bring billions of federal dollars to implement a major part of the president’s health care law.

The measure passed after last-minute legislative maneuvering. The Republican-led state Senate initially rejected it by one vote, and then huddled privately for several hours before returning to vote 20-18 to support it with a few significant caveats. The narrow approval sends the Medicaid expansion back to the House, which has already backed a similar bill.

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It’s now a near-certainty that a version of Medicaid expansion will land on the desk of Snyder, who had already broken with the GOP base to support the Obamacare program. Supporters say expansion will provide nearly half a million Michiganders with basic health insurance coverage. The federal dollars will also reach a state dealing with the fallout from Detroit’s bankruptcy.

“This is not Obamacare or the Affordable Care Act. This is our bill that will reform the cost of medicine in our state and be a model for our country,” said Republican Sen. Roger Kahn, chairman of the Senate Appropriations Committee.

In a late Tuesday news conference, Snyder said he hopes the House will once again pass the Medicaid expansion next week and send the bill to his desk.

“It’s about 470,000 Michiganders having a better life,” Snyder said, acknowledging Obamacare’s divisive politics. “Going to the ER for your health care, while we have wonderful people in the ER, is not a good solution.”

Approval at the state level doesn’t guarantee expansion, though. A unique provision that would require some Medicaid recipients to leave the program after four years or face co-pays or deductibles still would need approval from federal Medicaid officials.

Democrats were united in favor of expansion but Republicans split. Opponents ripped it as an unaffordable Big Government expansion, and one state senator, Patrick Colbeck, initially refused to vote in order to prevent the lieutenant governor from casting the deciding tie-breaking vote for expansion. Colbeck’s abstention left the first vote 19-18, one short of the 20 needed for passage.

“It’s nothing short of government control of our health care decisions,” said Colbeck.

The vote hands Snyder his first Obamacare victory after he whiffed twice in his effort to build an insurance exchange. Lawmakers rebuffed his plan for Michigan to construct its own exchange as well as his backup plan to partner with the feds on an exchange.

Tuesday’s vote erased a setback for Snyder in June, when the Senate ignored his plea to vote before the summer break. Snyder, who at the time rushed back from Israel to pitch lawmakers on the Medicaid expansion, practically begged them not to recess without approving the House-backed plan.

In the two months since, a bipartisan Senate working group had been meeting to tweak the House bill and flesh out Medicaid reforms. Lawmakers also added a provision appropriating federal funds for the Medicaid expansion — avoiding another fight over actually funding the program.

“It’s a big step for us because you can imagine how difficult it would be to have a second vote on this,” said Laura Appel, vice president of federal policy at the Michigan Health and Hospital Association.